Individual provider Active NPI

Sophia Banos

  • Speech-Language Pathologist
  • Oklahoma City, OK
National Provider Identifier
1700696341
Registry record updated Feb 28, 2025
On this page

Key facts

NPPES NPI Registry
Primary specialty
Speech-Language PathologistTaxonomy code 235Z00000X
License
CF658 Issued in OK
Practice address
11500 N Portland Ave
Oklahoma City, OK 73120-4625
Phone
(405) 548-4300
Fax
(405) 548-4350
NPI assigned
Jan 7, 2025
Sex
Female
Sole proprietor
Yes

NPPES NPI Registry

Updated by the provider on Feb 28, 2025

Registry information is reported by the provider to CMS and is not verified. About this source

Specialties & licenses 1

Specialty (taxonomy)CodeLicenseStatePrimary
Speech-Language Pathologist 235Z00000X CF658 OK Primary

Addresses

Primary practice location

11500 N Portland Ave
Oklahoma City, OK 73120-4625

Mailing address

11500 N Portland Ave
Oklahoma City, OK 73120-4625
Phone (405) 548-4300

Other practice location 1

2272 36th Ave NW Ste 200
Norman, OK 73072-3251
Phone (405) 767-4200

Other practice location 2

8125 E 101st St Ste 50
Tulsa, OK 74133-7245
Phone (918) 392-7600

Medicare participation

Medicare enrollment files
Medicare fee-for-service enrollment
Enrolled in OK

Enrollment records 1

Enrollment IDStateProvider typePAC IDDetails
I20250630002156 OK Practitioner - Qualified Speech Language Pathologist 2163935586 Reassigns benefits to 1 organization

National Provider Directory

National Provider Directory
Medicare enrollment (NPD)
Enrolled

State licenses

LicenseStateTypeSpecialty
6450OKMDProfessional Counselor
CF658OKMDSpeech-Language Pathologist

Practice roles

OrganizationSpecialtyStatusNew patients
Hearts for Hearing Foundation Speech-Language Pathologist CurrentSince Jun 13, 2025 Accepting new patients

Locations

2272 36th Ave NW
#200
Norman, OK 73072
Phone (405) 767-4200

11500 N Portland Ave
Oklahoma City, OK 73120
Phone (405) 548-4300

8125 E 101st St
Ste 50
Tulsa, OK 74133
Phone (918) 392-7600

Organizations & group practices 1

Organizations this provider is connected to: Medicare benefit reassignments (the organization bills Medicare for this provider’s services), Care Compare group memberships and National Provider Directory roles.

NPI Registry JSON

The complete NPPES record for this NPI in the NPI Registry API format.

{
    "created_epoch": "1736208000000",
    "enumeration_type": "NPI-1",
    "last_updated_epoch": "1740700800000",
    "number": "1700696341",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "11500 N PORTLAND AVE",
            "city": "OKLAHOMA CITY",
            "state": "OK",
            "postal_code": "731204625",
            "telephone_number": "405-548-4300",
            "fax_number": "405-548-4350"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "11500 N PORTLAND AVE",
            "city": "OKLAHOMA CITY",
            "state": "OK",
            "postal_code": "731204625",
            "telephone_number": "405-548-4300",
            "fax_number": "405-548-4350"
        }
    ],
    "practiceLocations": [
        {
            "address_1": "2272 36th Ave NW Ste 200",
            "address_purpose": "LOCATION",
            "city": "Norman",
            "state": "OK",
            "postal_code": "730723251",
            "country_code": "US",
            "telephone_number": "405-767-4200",
            "fax_number": "405-548-4350",
            "country_name": "United States",
            "address_type": "DOM"
        },
        {
            "address_1": "8125 E 101st St Ste 50",
            "address_purpose": "LOCATION",
            "city": "Tulsa",
            "state": "OK",
            "postal_code": "741337245",
            "country_code": "US",
            "telephone_number": "918-392-7600",
            "fax_number": "405-548-4350",
            "country_name": "United States",
            "address_type": "DOM"
        }
    ],
    "basic": {
        "last_name": "BANOS",
        "first_name": "SOPHIA",
        "sole_proprietor": "YES",
        "sex": "F",
        "enumeration_date": "2025-01-07",
        "last_updated": "2025-02-28",
        "certification_date": "2025-02-28",
        "status": "A"
    },
    "taxonomies": [
        {
            "code": "235Z00000X",
            "taxonomy_group": "",
            "desc": "Speech-Language Pathologist",
            "state": "OK",
            "license": "CF658",
            "primary": true
        }
    ],
    "identifiers": [],
    "endpoints": [],
    "other_names": []
}

Other providers in Oklahoma City, OK

Sources for this page

  • NPPES NPI Registry (CMS): identity, addresses, specialties, licenses, identifiers and endpoints. Last updated by the provider on Feb 28, 2025; self-reported and not verified by CMS. Specialty names from the NUCC taxonomy.
  • Medicare enrollment (CMS PECOS): enrollments, PAC IDs and benefit reassignments.
  • National Provider Directory (CMS): practice roles, locations, licenses, networks and endpoints.

Verify at the official NPI Registry.